1.Administer 1 hour before or 2 hours after meals
2.Be sure that the client is adequately hydrated
3.Provide appropriate client education
4.advise client to avoid sunlight or to protect skin
5.instruct how to take drug, symptoms to report
6.advise client not to take with milk
instruct females to use alternative method of contraception while taking the drug

What antibiotics can cause birth control pills to be ineffective.

think taps!

Tetracycline
ampilicillin
PCN V
sulfonamides

What are some general guidelines when administering antibiotics

1.take on empty stomache or light snack
2.take with a full glass of water
3.if nausea is persistant DO NOT stop taking medication=call doctor

SULFONAMIDES AND URINARY ANTISEPTICS

What is the prototype ?

Trimethoprim-Sulfamethoxasole- (Bactrim) is the prototype

Sulfonamide

Other drugs used to treat UTIs include closely related drugs to sulfonamide.

give with food for GI upset
monitor appropriate labs for adverse drug effects, if hepatitis develops drug should be stopped
client and family education should be ongoing
it is important to stress the need for compliance with long term therapy and follow- up medical care for the duration of therapy

What symptoms would indicate that a client who is taking Isoniazid is experiencing hepatic toxicity?

malaise
jaundice
nausea

What can be given with TB drugs to minimize peripheral neuropathy?

Pyridoxine = Vitamin B6 25-50mg q/day

If a client is taking TB antibiotic drugs and is experiencing peripheral neuropathy, what is the client at risk for?

Risk for falls

A client who is taking Isoniazid should be instructed to avoid which substances?

Aminoglycosides= Gentamicin= What is the peak range and the trough range

5-8=peak
<2 = trough

Why is a peak and trough drawn with gentimicin=aminoglycoside??

because it is highly nephrotoxic

FLUOROQUINOLONES are used to treat.

Used to treat UTIs
URIs
pneumonia
gonorrhea.

Fluoroquilolones; drugs in this class

How are they given???

Ciprofloxacin
Levogloxacin=Levaquin
Norfloxacin

Mostly given PO

What adverse effects are associated with beta-lactam drugs and how may they be prevented or minimized?

Hypersensitivity: ask client about allergies to PCN before administering.
Phlebitis at IV site and pain at IM sites: mix according to directions and observe the site frequently.
Superinfection: use only when the organism has been identified.
Nausea and vomiting: administer with a full glass of water.
Diarrhea, colitis, pseudomembranous colitis: discontinue use and switch to another class of drug.
Nephrotoxicity: observe for adequate urine output; blood, urea, nitrogen; and serum creatinine.
Neurotoxicity: observe for confusion and neuromuscular irritability; if present, discontinue drug.
Bleeding: observe for ecchymosis and petechiae.

How are penicillins and other beta-lactam drugs excreted?

They are rapidly excreted by the kidneys in urine. An exception to this is nafcillin, which is excreted by the liver.

When giving injections of penicillin in an outpatient setting, it is recommended to keep clients in the area and observe them for at least 30 minutes. Why?

This time allows you to observe for hypersensitivity or anaphylaxis.

What are the signs and symptoms of anaphylaxis?

Rash, hives, difficulty breathing, dizziness, drop in blood pressure, fainting, and respiratory distress all signal an anaphylactic reaction that may be life-threatening.

For clients with renal impairment, which drugs in this chapter require reduced doses?

Most of the drugs, except nafcillin, require reduced doses.

What anti bacterial drugs from this chapter may cause pseudomembranous (antibiotic-associated) colitis?

Ampicillin and cephalosporins may cause pseudomembranous colitis.

Which viral infections may be prevented by administration of antiviral drugs?

Influenza A may be prevented by administering after exposure. AIDS may be prevented from transference to the fetus in utero with antiviral treatment. Viral vaccines may prevent poliomyelitis, measles, rubella, mumps, smallpox, chicken pox, and yellow fever. Vaccines are also available for influenza and rabies.

What are the major adverse effects associated with commonly used antiviral drugs? How would you assess for each of these adverse effects?

Many of these drugs are metabolized by the liver. LFTs and assessment of skin and sclera for jaundice are necessary. These drugs are primarily excreted by the kidneys, and creatinine clearance needs to be monitored as well as I&O and complaints of flank pain. Bone marrow depression can occur with ganciclovir.

Why is it important to monitor renal function in any patient receiving a systemic antiviral drug?